While caring for a client receiving total parenteral nutrition (TPN), it is most important for the nurse to monitor which of the client's lab values?

Urinary ketones.

Serum protein.

Serum osmolarity.

Capillary glucose.

Answer and Explanation

The Correct Answer is C

Choice A

Urinary ketones are not most important. Monitoring urinary ketones can provide information about the utilization of glucose and fat as energy sources. However, it is not the primary lab value to monitor in TPN administration.

Choice B

Serum protein is not most important. Monitoring serum protein levels is important to assess nutritional status, but it might not be as immediate a concern as serum osmolarity.

Choice C

Serum osmolarity is the most important. When caring for a client receiving total parenteral nutrition (TPN), monitoring serum osmolarity is most important. TPN is a highly concentrated solution containing various nutrients, and it is infused directly into the bloodstream. Serum osmolarity reflects the concentration of particles (such as electrolytes, glucose, and other solutes) in the blood. Monitoring serum osmolarity is crucial to prevent complications related to fluid and electrolyte imbalances that can arise from the administration of TPN.

Choice D

Capillary glucose is not the most important. Monitoring capillary glucose levels is important, especially in clients receiving TPN with added glucose. Hyperglycaemia is a potential complication of TPN. While glucose monitoring is important, it is secondary to monitoring serum osmolarity, which encompasses a broader range of solute concentrations.

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Correct Answer is D

Explanation

Choice A

Planning low carbohydrate and high protein meals is not recommended. While meal planning is important for weight loss, focusing solely on low carbohydrate and high protein meals may not be the most balanced or sustainable approach. It's essential to consider a variety of nutrients and food groups in the diet.

Choice B

Engaging in strenuous activity for an hour daily is not recommended. Jumping into strenuous activity for an hour daily might not be realistic or safe for everyone, especially for someone who is just starting their weight loss journey. A more gradual increase in physical activity is often recommended.

Choice C

Participating in a group exercise class 3 times a week is not recommended. Group exercise classes can be beneficial, but they may not address the whole spectrum of weight loss factors. Additionally, starting with three times a week might be challenging for someone new to exercise.

Choice D

Keep a record of food and drinks consumed daily is recommended. When helping a client with a BMI of 30 (which falls within the obese range) start a weight loss plan, keeping a record of food and drinks consumed daily can be an effective initial approach. This approach is often referred to as "food journaling" or "food tracking." It involves writing down everything the client eats and drinks throughout the day. This practice can help raise awareness of eating habits, identify patterns, and uncover areas where changes can be made to reduce calorie intake.

A. Canned cream of mushroom soup, tuna salad, and water. B. Bacon. lettuce, and tomato sandwich, grapes, and skim milk. C. Taco salad, refried beans, low fat ice cream and coffee. D. Chicken salad on toast, fruit-flavoured yogurt, and iced tea.

Correct Answer is B

Explanation

Choice A

Canned cream of mushroom soup, tuna salad, and water is inappropriate. Canned soups and processed foods like canned cream soups can be high in sodium. Tuna salad might also have added salt.

Choice B
B. Bacon, lettuce, and tomato sandwich, grapes, and skim milk is the appropriate selection. A serum sodium level of 155 mEq/L (155 mmol/L) is higher than the normal reference range (136 to 145 mEq/L or 136 to 145 mmol/L), indicating hypernatremia or high blood sodium levels. In this case, it's important for the client to choose foods that are lower in sodium to help manage their sodium intake.

Choice C

Taco salad, refried beans, low-fat ice cream, and coffee is inappropriate. Taco salad can contain salty ingredients, and refried beans can also be high in sodium. Processed meats and sauces used in tacos can contribute to sodium intake.

Choice D

Chicken salad on toast, fruit-flavoured yogurt, and iced tea is inappropriate. Chicken salad and some breads might contain added salt. Fruit-flavoured yogurts can also have added sugars, and iced tea can vary in sodium content depending on how it's prepared.

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While caring for a client receiving total parenteral nutrition (TPN), it is most important for the nurse to monitor which of the client's lab values?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client who has a body mass index (BMI) of 30 is requesting information on the initial approach to a weight loss plan. Which action should the nurse recommend?

Correct Answer is D

Explanation

A client has a serum sodium level of 155 mEq/L (155 mmol/L). The nurse should encourage the client to make which selection from the lunch menu? Reference Range Sodium [Reference Range: Adult 136 to 145 mEq/L or 136 to 145 mmol/L]

Correct Answer is B

Explanation

During the admission assessment, an older male client who has no teeth tells the nurse that he can not find his dentures at home. His dietary prescription is a regular diet. What diet request should the nurse recommend for this client?

The nurse is reviewing a nutrition plan with a client newly diagnosed with hypertension. Which statement by the client indicates an understanding of the Dietary Approaches to Stop Hypertension (DASH) diet?

A young adult client with a history of iron deficiency anaemia has a haemoglobin of 10.5 g/dL (6.52 mmol/L). Which food choice should the nurse recommend to this client? Reference Range Haemoglobin (Hgb) [Reference Range: Male: 14 to 18 g/dL or 8.7 to 11.2 mmol/L]

A client expresses an interest in reducing intake of saturated fats and plans to stop eating hamburgers at lunch. Which menu item should the nurse suggest as an alternative source of protein?

The nurse instructs a client with Type 2 diabetes mellitus (DM) to avoid refined sugar and carbohydrates. Choosing which food indicates that the client understands the diet teaching?

The nurse is caring for a client diagnosed with type 1 diabetes mellitus who uses both short-acting and long-acting insulin adjusted doses throughout the day. Which nutrient is essential for the client to count for each meal and snacks?